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Student Use Form
Student Use Form
Student Technology Form
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Scholar Name
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required
First Name
Last Name
Street Address
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required
Must contain only letters, numbers and spaces
City
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required
Must contain only letters and spaces
State
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required
Must contain only letters and spaces
ZIP Code
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required
Must contain only letters and spaces
School Name
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required
UPA Elem - Ellen Thompson
UPA Elem - Ellen Thompson
UPA Middle
UPA High
UPSM Elem
UPSM Middle
UPSM High
UPAD Elem
UPAD Middle
UPAD High
School Grade
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required
K
1
2
3
4
5
6
7
8
9
10
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Do you currently have internet access at home?
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required
Yes
No
Please check one of the following options for your scholar’s technology needs for the 24-25 school year.
*
required
YES, my scholar will require the use of a U Prep Schools Chromebook for the 2024-2025 school year. (Please complete Parent Liability form)
NO, I decline the use of a U Prep Schools Chromebook for the 2024-2025 school year. My scholar would like to use their own technology device, at home as well as school. I understand that my scholar will still be responsible for completing all assignments
Parent / Guardian Name
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required
First Name
Last Name
Parent / Guardian Email Address
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Parent / Guardian Consent
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required
By checking this box, you agree to the terms outlined above.
I agree to this technology needs assessment
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